Despite all that is known about the causes and impacts of suicide, population-specific statistics are not widely available and often do not describe the full extent of the problem. As a priority, governments and stakeholders have undertaken substantial efforts to understand the root causes of suicide and to chart a path towards a “low-suicide reality”. Disparities in suicide mortality are so stark that suicide prevention has become a public health priority for many Indigenous communities and governments. Although incidence rates vary by community and region, studies consistently show that Inuit, First Nations, and Métis have disproportionate rates of suicide compared to non-Indigenous populations. Suicide is a leading cause of death among Indigenous peoples in Canada. Overall, the strategies we propose can build on the strengths of the existing national suicide surveillance system by adopting a collaborative and inclusive governance model that recognizes the stake Indigenous communities have in suicide prevention. Specifically, we recommend establishing an independent community and scientific governing council, integrating Indigenous identifiers into population health datasets, increasing geographic coverage, improving suicide data quality, comprehensiveness, and timeliness, and developing a platform for making suicide data accessible to all stakeholders. To enhance capacity for suicide surveillance, we propose strategies to better track progress in Indigenous suicide prevention. We then review recent data on the epidemiology of suicide and suicidal behaviour among Indigenous populations, and identify challenges related to national surveillance. To better understand these challenges, we discuss the policy context for suicide surveillance and examine the survey and administrative data sources that are commonly used in public health surveillance. This paper provides a critical analysis of the challenges related to suicide surveillance in Canada and assesses the strengths and limitations of existing data infrastructure for monitoring outcomes in Indigenous communities. Consequently, this limits the ability to achieve public health prevention goals and reduce suicide rates and rate inequities. These challenges hamper efforts to detect changes in population-level outcomes and assess the impact of suicide prevention activities. ![]() ![]() National health data systems lack Indigenous identifiers, do not capture data from some regions, and do not routinely engage Indigenous communities in data governance. ![]() However, public health systems continue to face challenges in monitoring the population burden of suicide and suicidal behaviour. Indigenous communities and organizations have designed local and regional approaches to prevention, and the federal government has developed a national suicide prevention framework. Indigenous peoples in Canada experience disproportionate rates of suicide compared to non-Indigenous populations.
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